Provider Demographics
NPI:1457396202
Name:RIVER STREET ASSOCIATES
Entity Type:Organization
Organization Name:RIVER STREET ASSOCIATES
Other - Org Name:RIVERSTREET MANOR
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CORPORATE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JANE
Authorized Official - Middle Name:
Authorized Official - Last Name:DROPESKEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-925-4231
Mailing Address - Street 1:101 E STATE ST
Mailing Address - Street 2:
Mailing Address - City:KENNETT SQUARE
Mailing Address - State:PA
Mailing Address - Zip Code:19348-3109
Mailing Address - Country:US
Mailing Address - Phone:610-925-4436
Mailing Address - Fax:610-925-4351
Practice Address - Street 1:440 N RIVER ST
Practice Address - Street 2:
Practice Address - City:WILKES BARRE
Practice Address - State:PA
Practice Address - Zip Code:18702-2631
Practice Address - Country:US
Practice Address - Phone:570-825-5611
Practice Address - Fax:570-824-6488
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-17
Last Update Date:2018-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA185302314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0009934840001Medicaid
37414OtherHEALTH AMERICA
395691OtherBC OF NEPA - BC#
073877OtherBC OF NE PA -FPH#
30972OtherGEISINGER HEALTH PLANS
317140OtherUS FAMILY HEALTH PLAN
457385OtherAETNA-HMO
IY1100OtherHEALTHNET OF PA
PA0009934840001Medicaid
30972OtherGEISINGER HEALTH PLANS
37414OtherHEALTH AMERICA
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